个体化仿真手术在肝血管瘤手术治疗中的应用价值  

The value of individualization simulation surgery in the surgical therapy of hepatic hemangioma

作　　者：方驰华[1] 黄燕鹏[1] 鲁朝敏[1] 李晓锋[1] 廖其光[2] 吴东波[1] 

机构地区：[1]南方医科大学珠江医院普外科,广州510282 [2]华南师范大学计算机学院

出　　处：《中华实验外科杂志》2008年第8期1068-1070,1092,F0003,共5页Chinese Journal of Experimental Surgery

基　　金：国家高科技研究发展“863”计划（2006AA02Z346）;广东省自然科学基金团队项目（6200171）;国家自然科技基金资助项目（30470493）;广东省科技计划资助项目（2003C34303）

摘　　要：目的探讨个体化仿真手术在肝血管瘤外科手术中的应用价值。方法利用1例肝血管瘤患者64排螺旋CT扫描数据集，在自主开发的图像处理软件对图像进行分割及三维重建，将重建模型导入到FreeForm Modeling System进行修饰和平滑。使用系统的力反馈设备PHANToM进行肝血管瘤术前仿真手术研究，选择适合本例患者的手术方式。结果重建的肝脏、肝内管道系统、血管瘤模型形态逼真，立体感强；各管道系统的分布、走行以及相互关系明晰；在建立的仿真手术系统的仿真环境中，使用“仿真手术刀”仿真了肝血管瘤的手术过程，仿真手术符合临床手术过程并有力的反馈作用。结论可视化三维重建模型有利于肝血管瘤手术治疗方案的合理选择；术前的手术设计和可视化演示可提高手术效果，降低手术风险及减少手术并发症。Objective To explore the application value of individualization simulation surgery in the surgical therapy of hepatic hemangioma. Methods One patient with hepatic hemangioma was scanned by 64-slice helicon computerized tomography （CT） and the data was collected. The image from the CT was carried out to be segmented and three-dimensional （3D） reconstruction by the medical image processing system which was exploited by us. The 3D models were imported to the FreeForm Modeling System for smoothing and modifying. Irregulation hepatic segments resection and stripped of hepatic hemangioma was simulated with the force-feedback equipment （PHANTOM）. Finally, the suitable operation strategies of the patient whom we study were chosen. Results The models have high fidelity and strong 3D effect for the interhepatic artery and vein and portal vein and bile duct, and their spatial disposition and course and interrelationship are shown clearly. In the simulation surgery system, the scalpel can be manipulated on 3D models with PHANTOM. The simulation effect is the same as the clinical operation for hepatic segments resection and stripped of hepatic hemangioma. Life-like can be felt and power feeling can be touched during simulation operation. Conclusion The visualized models are helpful to choose reasonable therapeutic regimen for hepatic hemangioma ; The suitable operation strategies of this ease was to combine together irregulation hepatic segments resection and stripped of hepatic hemangioma ; It can improve the surgical effect, decrease the surgical risk and reduce the complication through demonstrating visualized operation before surgery.

关 键 词：肝血管瘤 三维重建 仿真手术 治疗方案 

分 类 号：R735.7[医药卫生—肿瘤] R540.41[医药卫生—临床医学]